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Unequal prospects: Disparities in the quantity and quality of labour

supply in sub-Saharan Africa

Sender, J.; Oya, C.; Cramer, C.

Citation

Sender, J., Oya, C., & Cramer, C. (2005). Unequal prospects: Disparities in the quantity and quality of labour supply in sub-Saharan Africa. Asc Working Paper Series, (62). Retrieved from https://hdl.handle.net/1887/12885

Version: Not Applicable (or Unknown)

License: Leiden University Non-exclusive license

Downloaded from: https://hdl.handle.net/1887/12885

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African Studies Centre

Leiden

Unequal prospects:

Disparities in the quantity and

quality of labour supply

in sub-Saharan Africa

John Sender, Christopher Cramer and Carlos Oya*

ASC Working Paper 62/2005

*The authors would like to thank Deborah Johnston for substantive work on earlier drafts of this paper. The Centre for Development Policy Research at the School of Oriental and African Studies, University of London provided administrative support and Ruchira Joshi helped in compiling the bibliography.

This paper was commissioned for the World Bank by Arvil van Adams, Senior Advisor for Social Protection – Africa Region, who has also given helpful comments. The authors and the World Bank gratefully acknowledge the financial support given for this project by the German government. The findings, interpretations and

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Contents

1. Introduction 2

2. Cross-Country Comparative Data on Labour Supply

2.1 Introduction: Data Inadequacies 5

2.2 Basic Demographic Characteristics:

Population Size, Growth Rates and Age Composition 8

2.3 The Impact of HIV/AIDS on the Prime Age Adult Labour Supply 11

2.4 The Impact of HIV/AIDS on Child Labour Supply 13

2.5 The Impact of HIV/AIDS on the Labour Supply of Youth 19

2.6 Summary and Conclusions 20

3. The Quality of Labour in the Future: Nutrition, Health, and Educational Status

3.1 Cross-Country Comparative Data: Life Expectancy, Literacy, Nutrition

and Mortality 22

3.2 Intra-Country Differentials in Education and Health Status 25

3.3 Summary and Conclusions 31

4. Improving the Quality of Labour Supply: Constraints and Policy Opportunities

4.1 Introduction 32

4.2 Teachers and Conditional Cash Transfers for Schooling 33

4.3 Health Workers 36

4.4 Vocational Education, Training and Skills 38

4.5 Summary and Conclusions 41

5. Characteristics and Determinants of Labour Mobility: Opportunities for Poverty Reduction

5.1 Introduction 42

5.2 Migration, Emigration and Immigration: Cross-Country Comparative

Data 43

5.3 International Flows of Skilled Labour 46

5.4 Refugees, Forced Migrants and Internally Displaced People 47

5.5 Trafficking 48

5.6 Violence and Labour Supply 49

5.7 Transport and Communicatio ns Infrastructure 53

5.8 Summary and Conclusions 56

6. Conclusions: Some Implications of a New Policy Focus on the Poorest, Most Disadvantaged Labour Force Entrants

6.1 National Data Gaps 58

6.2 Microeconomic Research on Unregistered/Unrecorded Wage Labour

and the Need for New Modules for LSMS 59

6.3 Sectoral Priorities for Pro-Poor Investment 62

6.4 Voice and the Bargaining Power of Disadvantaged Labour 64

Appendix tables 67

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1. Introduction

The issue of labour supply in Sub-Saharan Africa, like so many other economic and social issues in the region, is often discussed as if the whole sub-continent faced essentially similar, overwhelming and intractable problems. This pessimistic and over- generalised literature has been criticized elsewhere (Sender, 1999). By contrast, this paper stresses the importance of differences between and within Sub-Saharan African economies in the quantity and quality of labour supplies, and highlights the scope for policies to overcome constraints on employment prospects. The paper also points to the dangers of one-size-fits-all policy recommendations for the labour market, while at the same time identifying certain similarities in the characteristics of the most disadvantaged labour market entrants in many Sub-Saharan African

economies. The aim is to begin to isolate the sub-set of policies that might be most relevant for these entrants, if donors and governments wish to re-allocate resources to improve prospects for the poorest Africans.1

Not all relevant policies can be discussed. For example, countries "severely affected" by HIV/AIDS will need to adopt a different range of policies towards labour supply from countries with lower prevalence rates, but the details of preventive and curative policy options are not explored. The paper describes the complex effects of violence and violent conflicts on many aspects of labour supply, but does not discuss post-war reconstruction policy initiatives, or interventions to reduce conflict. And policies that influence the demand for labour will have dramatic dynamic effects on the quantity and quality of labour supplied, but are largely ignored in this paper. Historically, when demand for labour has been strong in Sub-Saharan Africa labour inputs have responded in a number of ways. Participation rates have increased; and labour migration has risen in response to demand for imported labour. It is also well-known that rising demand for labour generates improvements in the quality of the labour force, through learning-by-doing processes and static and dynamic returns to scale. This paper is not concerned with the detailed analysis of appropriate macroeconomic strategies to achieve the level of demand required for rapid growth. The paper does, however, examine some of the barriers that workers in different countries currently face in responding to changing demand conditions in the labour market. These include transport and other barriers to labour mobility (Section 5); the structured disadvantage experienced by women and certain other categories of worker (Section 2); the

inadequacy of information, communication and money transmission facilities available to workers (Section 5); and government policies that are, to different

degrees in different economies, limiting some workers’ access to the basic education, primary health care and the negotiating skills that are required for advantageous participation in labour markets (Sections 2-4).

The paper also details the inadequacy of existing data and research on the poorest labour market entrants, particularly in a context of uneven and unreliably recorded HIV/AIDS prevalence. In addition to identifying some priorities for future research and the design of more relevant surveys, the paper concludes, on the basis of available

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evidence on the characteristics of these entrants, that too much emphasis has been placed on the issue of unemployment and on the existing and potential role of

self-employment in the survival strategies of the poorest people. A new focus on the large

number of poor women and men who participate in the labour market as workers for wages is required. It is necessary to identify those sectors that, in the short- to

medium term, are likely to provide them with the forms of wage employment that are crucial for their survival. Trends in the real wages of these unrecorded workers should be monitored to assess progress in poverty reduction. The paper also highlights some other important data and research gaps. It is argued that more resources need to be devoted to understanding and recording the scale and patterns of labour force mobility within and between countries and from Africa to the rest of the world and that,

similarly, more resources should be committed to monitoring the scale, determinants and consequences of violence, especially violence against girls and women.

There are several important barriers impeding the entry of the poor into forms of wage employment upon which they are most dependent. Some of these barrie rs can be lowered by appropriate investments in transport, communications and money transmission facilities. Others, including gender discrimination (see above) and the political and institutional factors reducing the bargaining power of both male and female wage workers, will only be overcome by less familiar policy initiatives, including legislation and investment to protect the workplace rights of "illegal" migrants and expenditures to improve workers' organisational capacity. Less controversially, the paper argues for targeted interventions that focus on increasing both the supply of and effective demand for rural schooling.

The paper is organised as follows: Section 2 focuses on the quantity of labour supplies. It begins by highlighting data inadequacies; it then proceeds to a discussion of the basic demographic trends that have influenced and will continue to influence the quantity (and quality) of the labour supply in different Sub-Saharan African countries, highlighting disparities between countries. Section 2 then discusses general patterns and inter-country variations in the labour supplies of prime age adults, children (including orphans), and youth. It examines these supplies in the context of the impact of HIV/AIDS, emphasising the difficulties involved in the projections of the labour market impact of the epidemic.

Sections3 and 4 analyse the quality of labour supplies.2 Section 3 provides evidence on inter- and intra-country inequalities in the distribution of education, health and other services, in order to emphasise the fact that the labour supply from some regions and some households will have very different capacities to work productively. This section makes the case for policies that prioritise the bottom quintile of each country's rural population, which can be identified using robust and readily available asset or welfare indicators. However, it is also argued that designing appropriate,

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specific policies will require improved survey data and methods, an argument that is taken further in Section 6.

Section 4 identifies the potential for policy reform to improve the future quality of African labour supplies. The main influences on labour quality are the capacities to educate and to improve the health and skills of the next generation of workers. A robust analysis of these capacities, e.g., in schooling, is impeded by the paucity of country-specific data. Obviously, HIV/AIDS affects the quality of future labour supplies, but this too is not immune to policy. This Section emphasises the need to shift expenditures and incentives in order to encourage tertiary education enrolment and more effective recruitment of teachers to work in poor rural areas. Other policy interventions may also help to improve the poorest children’s access to education, including payments to mothers conditional on their children’s school attendance, free school meals for poor children and orphans, abolishing requirements for uniforms, and eradicating user fees. Similarly, Section 4 highlights the case for redirecting donor and government spending to achieve a higher density of health workers, as well as reorienting health delivery systems so that they focus less on curative facilities in relatively well off areas and more on rural, preventative facilities staffed by

community nurses and other auxiliary health workers (who are also less likely to emigrate than more professionally trained health workers). Section 4 also discusses technical, vocational education, training and skills programmes. It concludes, first, that there is no evidence that these have been an effective mechanism for enhancing basic labour market skills and, second, that their objectives may more effectively and progressively be met by investing in basic literacy and numeracy and by enhancing all workers’ capacities to negotiate with employers and to press for improved in-service training.

Section 5 focuses on labour mobility, arguing that many forms of mobility are important to poverty reduction and that constraints on mobility restrict the growth of labour productivity and poverty eradication efforts. It traces the main patterns of mobility in Sub-Saharan Africa, emphasising the vast scale and unevenness of

mobility, the variety of factors affecting mobility and the inadequacy of the data. The roles of violence and direct and indirect forms of coercion in propelling population movements and creating labour supplies are stressed. The section then examines the available data on flows of migrants from Africa to the rest of the world and to other African countries, before focusing on international flows of highly skilled labour, the remittances of these skilled workers and other implications of these flows. A larger group of Sub-Saharan cross-border migrants are then examined, namely: refugees, forced migrants and displaced people. The Section continues with a brief discussion of the evidence on trafficking, followed by a more detailed analysis of the relationship between violence and labour supply. The policy implications, apart from the urgent need to invest in transport and communications infrastructure, are discussed in the final part of this Section. They include the need to recognise and record more accurately migrant African labourers as a foundation for interventions to facilitate their mobility and to protect them from abusive relationships.

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throughout this paper is on the conditions affecting labour supply among those in the poorest quintile of the population. This Section argues that encouraging growth in sectors that are intensive in the use of unskilled (female) labour will determine

whether or not many of the poorest labour market entrants can survive. However, it is also important to increase the organisational and bargaining capacity of workers in these and other sectors, because there is no automatic mechanism smoothly linking employment expansion to poverty reduction. Further, concentrating on those

particular sectors (and geographical areas) will make it easier, in the context of scarce resources and fiscal constraints, to make some progress with the other policies

recommended throughout this paper, including the construction and maintenance of health facilities and the recruitment and motivation of primary school teachers.

2. Cross-Country Comparative Data on Labour Supply

2.1 Introduction: Data Inadequacies

Population Censuses and Labour Force Surveys are commonly used as primary sources of information on labour supply. These sources are used throughout this Section. However, very few countries in Sub-Saharan Africa have carried out Labour Force Surveys (LFS) and Censuses are often outdated (Tables A1 and A11). Yet, many outdated Censuses have been used as sampling frames for Living Standards Measurement (Household Budget) Surveys (LSMS) and for Core Welfare Indicators Questionnaire Surveys (CWIQS), which are increasingly becoming the main source of information used for labour market policy making. In fact, more than 45 LSMS and 18 CWIQS have been completed or begun since the mid-1980s3, whereas only 10 LFS are included in the survey lists published by the World Bank. In 1994, a WB study on labour markets and structural adjustment only included three Sub-Saharan African country case studies (Kenya, Ghana and Cote d’Ivoire), of which just one was based on a labour force survey (Kenya).

Nevertheless, Labour Force Surveys and Population Censuses remain the primary sources for the ILO database (LABORSTA http://laborsta.ilo.org), providing the data for measures of the economically active population, employment-to-population ratios and the growth of the labour force, by gender and age groups (Behrman and

Rosenzweig, 1994: 161). The response rates for a number of important indicators in Sub-Saharan Africa are low: zero percent for employment-to-population ratios, 14 percent for unemployment rates and 2 percent for youth unemployment rates

(Schaible and Mahadevan-Vijaya, 2002: 2). The gaps in the data, both for individ ual countries and periods of time, have two implications. First, many countries in Sub-Saharan Africa have no reliable data on labour supply and we know practically nothing about labour demand and labour market dynamics in these countries. Second, the data shown for the countries covered are often based on estimates and projections that rely on brave assumptions concerning population dynamics (natural rates of growth, age composition and migration), as well as on assumptions about the distribution of the labour force by sector, occupation and status.

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It is, therefore, hardly surprising that different agencies publish very different estimates for key labour market statistics. For example, African Development Indicators 2003 shows interpolated data on the labour force (economically active population) for a complete time series. The ILO database presents data from the primary sources, so not all years are included. In Ethiopia, it is striking to note that the World Bank records a labour force of nearly 17 million people in 1980, while

according to the ILO database there are only 14 million economically active people. In a number of random checks for the sample of countries covered in this paper similar inconsistencies appear between these two data sources, which is surprising because the ILO is cited as the source for the World Bank series.

This Section provides a cross-country comparative analysis of the underlying

demographic determinants of the total labour supply. Trends in the quantity of labour supplied by adults, children and youth are discussed in the subsequent sub-Sections. It is regrettable that more reliable data were not available, particularly to analyse the impact of HIV/AIDS on labour supplies. The starting point for any analysis of the impact of HIV/AIDS should be recent data on prevalence and mortality rates.

Unfortunately, there is remarkably little good quality information available that would enable the levels and thus trends in national HIV prevalence rates to be accurately monitored (Bennell, 2003a). No country in Sub-Saharan Africa collects reliable “vital registration” data on deaths.4 As a consequence, all figures describing the number of AIDS-related deaths in Africa are estimates of some kind (Ngom and Clark, 2003: 3). UNAIDS warn that their published estimates of HIV prevalence should be viewed as having an accuracy of +/- 25 percent (Zaba et al, 2003: 13).

There is little population-based survey data providing information on age and gender-specific HIV infection rates by location and socio-economic background. Instead, HIV prevalence estimates rely on the testing of those pregnant women who attend public sector antenatal clinics (ANCs). This is not an accurate method for measuring national, age-specific, or male prevalence le vels. Inaccuracies arise because:

• Sentinel surveillance in ANC clinics has an inherent selection bias against women using modern contraceptives. Women who have adopted consistent condom use are less likely to become pregnant and to attend the clinics.

• In the countries with more mature epidemics, there is some concern that ANC data may underestimate HIV prevalence, because of falling fertility among HIV positive women (Whiteside et al, 2003:10-11). If fertility is considerably lower among HIV-positive wo men, available estimates of HIV prevalence may be downwardly biased (United Nations, 2004c: 26).

• Rural data are biased towards larger villages and settlements close to towns and roads. Rural samples tend to be small and have often been biased towards more seriously affected rural areas (Dyson, 2003: 428). Very poor rural women and those living in more remote rural areas are less likely to attend antenatal clinics, as suggested by the data in Table 10.

It is hoped that the inclusion of HIV-testing of adults in the more recent DHS nationwide population-based samples in Malawi, Kenya and Uganda will provide

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more accurate estimates of age- and location-specific prevalence. However, both DHS and ANC data have to be combined with population census data to estimate national prevalence rates. If the last census is judged to have been unreliable, DHS may be forced to use another sampling frame, such as the electoral lists in

Mozambique; but these electoral lists may well not be accurate.5

Moreover, as noted above, the published population census data for many

Sub-Saharan African countries are often five or more years old (US Census Bureau, 2004), e.g. in Swaziland, Lesotho, Malawi, Mozambique, Cote D'Ivoire and Ethiopia. Large population shifts may have taken place in the intervening years (see below, Section 5), as a result of war, famine and forced migration, and changes in fundamental demographic variables such as fertility rates may have been faster than expected. There are, in addition, several other problems with the African population census data used to derive not only estimates of HIV prevalence, but also all labour force

estimates. Undercounting may be caused by logistical difficulties, accessibility and risk; misreporting is difficult to correct in the absence of alternative cross-checking lists;6 and censorship by governments may affect the published estimates of the regional breakdown of the population. In sum, the combination of unreliable prevalence data with unreliable population census data is bound to exacerbate the problem of interpreting the results.

Projections of the impact of HIV on the labour supply need strong assumptions about the distribution of the time of progression from HIV infections to AIDS and from AIDS to death. Very small changes in the assumptions made regarding progression time have important effects on projected mortality, but it is acknowledged that there is a great deal of uncertainty about the reliability of the particular assumptions made by UNAIDS and used in the Population Division's 2004 projections of the impact of HIV (United Nations, 2004c: 26). Similarly, for its projections of labour supply, the ILO has made assumptions about the duration of the periods when individuals are first partially and eventually fully unable to work without treatment and before death. Thus, they define a stage during which a person living with HIV/AIDS is bedridden for up to 50 percent of the time and can only work for 50 percent of the time (Stage3); and another, when a person is bedridden for more than 50 percent of the time and cannot work at all. However, the ILO admits that its assumptions are based on "a very small" body of literature on the progression of HIV/AIDS from the onset of symptoms to death (ILO, 2004a: 67). The first empirical evidence available on the impact of HIV/AIDS on labour productivity, also published in 2004, suggests that pre-AIDS morbidity affects the ability and productivity of infected workers over a substantially longer period of time than has previously been recognised (Fox et al, 2004:323). Unfortunately, the problems in projecting the size and timing of the impact of HIV/AIDS on women, men and children in different Sub-Saharan African countries

5 In the recent DHS for Nigeria the sampling frame was the list of enumeration areas developed for the dated and unreliable 1991 Population Census (DHS, 2004, 211). Other evidence suggests that the quality of data collected in the Nigerian DHS may be low (Case et al, 2002, 6).

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are much more complex than suggested in the previous paragraphs (Ngom and Clark, 2003; Zaba et al, 2003; Gregson et al, 2002). For example, these projections depend on weakly grounded assumptions about population-specific behavioural factors, such as current and future sexual networking preferences, as well as on assumptions about vertical transmission rates under different treatment regimes in the future. Projections also depend upon future trends in conflict and violence in Sub-Saharan Africa, since wars are known to spread infection (Section 5). But it is difficult to conceive a method of predicting the outbreak of wars. As Keynes noted when referring to the prospects of a European war, "About these matters there is no scientific basis on which to form any calculable probability whatever. We simply do not know!" (Keynes, 1937, 241). 2.2 Basic Demographic Characteristics: Population Size, Growth Rates and

Age Composition

Despite the data limitations noted above, there is little doubt that the basic

demographic characteristics that will continue to influence the supply of labour, both the absolute supply and its quality, differ very substantially between the economies of Sub-Saharan Africa. This is true not only in the trivial sense that the current working age population is, for example, about 25 times larger in Ethiopia than in Swaziland, Lesotho or Mauritania; there are also significant differences in the recent and projected growth rates of the population and labour force between countries. For example, between 2000 and 2005, the estimated annual rate of growth of population in Uganda is 3.24 percent and in Mauritania, Ethiopia, Senegal and Ghana it is well over two percent, whereas in Lesotho it is barely positive (0.14 percent) and in five other countries in our sample it is only 1.6 percent or below (Table 1).

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Table 1: Total Population and Population Growth Rates, 2000-2005

Total Population 2005 (Thousands)

Annual Population Growth (%) Years: 2000-2005 (Medium Variant) Cote d'Ivoire 17,165 1.62 Ethiopia 74,189 2.46 Ghana 21,833 2.17 Kenya 32,849 1.45 Lesotho 1,797 0.14 Malawi 12,572 2.01 Mauritania 3,069 2.98 Mozambique 19,495 1.75 Senegal 10,587 2.39 South Africa 45,323 0.59 Swaziland 1,087 0.80 Tanzania 38,365 1.93 Uganda 27,623 3.24 Zambia 11,043 1.16 Sub-Saharan Africa 732,510 2.28

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Table 2: Urbanization in 2003 and Projected Rates of Urbanization, 2005-2010a Percentage of the

Population Urban (2003)

Annual Rate of Change of Percentage Urban 2005-2010 (%) Cote d'Ivoire 45 1.1 Ethiopia 16 1.9 Ghana 45 1.0 Kenya 40 2.4 Lesotho 18 1.2 Malawi 16 2.6 Mauritania 62 1.6 Mozambique 36 2.7 Senegal 50 1.3 South Africa 57 0.8 Swaziland 24 1.0 Tanzania 35 2.5 Uganda 12 1.1 Zambia 36 1.1 Africa (2005) 40 3.4

Source: United Nations (2004a). a

In this and many other tables of t his paper numbers have been rounded from the original source.

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Table 3: Median Age, the Working Age Population as a Percentage of the Total Population, and Projected Dependency Ratios

Working Age Population as % Total Population (2000)* Median Age of the Total Population (2000)* Projected Dependency Ratio: Dependents per 100 Nondependent Persons (2005)** Cote d'Ivoire 52.3 18.1 78 Ethiopia 49.5 16.9 93 Ghana 53.9 18.8 73 Kenya 52.4 17.7 76 Lesotho 52.6 18.8 79 Malawi 49.2 17.1 101 Mauritania 51.4 18.2 … Mozambique 50.9 17.8 88 Senegal 51.8 17.6 … South Africa 60.1 22.6 57 Swaziland 50.9 17.4 87 Tanzania … 16.8 88 Uganda 46.2 15.1 112 Zambia 51.4 16.7 99 Sub-Saharan Africa 50.9 17.5 87 Asia (5 Countries) 26.1 49** Eastern Asia 64.9 30.8 South-Central Asia 57.4 22.4

Sources: *United Nations (2003); ** (ILO, 2004a: 74).

2.3 The Impact of HIV/AIDS on the Prime Age Adult Labour Supply

In many of the high prevalence countries in Southern Africa, less than 40 percent of current survivors to age 15 will celebrate their sixtieth birthdays (Ngom and Clark, 2003: 2).7 For both females and males of working age, higher national HIV

prevalence rates increase the probability of dying between the ages of 20 and 60, but the impact on females in this age group generally occurs at younger ages and is more focused on a narrow age band (ibid: 7). Thus, throughout Sub-Saharan Africa young women (aged 15-24 years) are twice as likely as young men to be living with

HIV/AIDS (UNICEF, http://www.unicef.org/lifeskills/index.html). Recent South African data

indicate even greater gender disparities, with females in this age group being 3 times more likely to be infected than males (Bradshaw et al, 2004:140). About a quarter of the slightly older young adult females (aged between 20 and 24 years) are HIV

positive in South Africa, compared to only 7.6 percent of males in the same age group (RHRU, 2004: 29). A smaller survey in Kenya found that over 27 percent of girls aged 15-19 were infected with HIV compared to 4.6 percent of boys in the same age group (Glynn et al, 2001).

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In high prevalence countries such as South Africa, as well as in areas like Kisumu (Kenya), the death of large numbers of relatively young adult females has important short- and medium- term implications for the age composition of female labour supplies and for the care- giving obligations of older women, who will devote years of labour to washing, feeding and nursing the chronically ill (Steinberg et al, 2002:15). There are also important implications for the children of this large group of women, since they will receive relatively few years of maternal care. The implication is that the nutritional status and the quality of the future labour force will be adversely affected.8 Children will be deprived "of those very things they need to become economically productive adults – their parents’ loving care, knowledge and capacity to finance education" (Bell et al, 2003:92).

These inter-generational productivity effects will probably have more obvious and serious economic consequences than those suggested by the aggregative quantitative changes in labour supply projected by the ILO. The proportion of the total labour force that will have died as a result of HIV/AIDS by 2005 appears to be quite small in Sub-Saharan Africa as a whole (3.2 percent), according to ILO definitions of the labour force and ILO projections,9 although this proportion is obviously much higher in some countries than others (Table 4).

Table 4: Estimated and Projected Labour

Force Losses as a Result of HIV/AIDS

Countries in Alphabetical Order

Estimated number of persons 15-64 years in the labour force who

are HIV positive in 2003

Projected Cumulative mortality losses to the total labour force as a result of HIV/AIDS, as an equivalent proportion of the total labour force, 2005

Côte d’Ivoire 399,400 5.2 Ethiopia 1,336,766 2.1 Ghana 292,297 1.5 Kenya 1,003,534 4.2 Lesotho 211,300 8.3 Malawi 737,700 6.9 Mozambique 1,128,500 2.4 South Africa 3,698,827 2.5 Swaziland 134,100 4.9 Uganda 454,242 8.4 Tanzania 1,401,300 3.3 Zambia 726,800 10.2 Total (Sub-Saharan Africa, 35 Countries, Weighted ) 18,610,517 3.2 Total (Asia, 5 countries) 4,886,600 0.2

Source: ILO, 2004a.

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Household expenditures on child-related goods – in particular on healthy foods – are lower when a child's biological mother is absent (Case et al, 2002: 2).

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There is disaggregated evidence to suggest that the risk of HIV-related death is particularly high for those young female adults who have few years of education (UNICEF, 2004b). Thus, in South Africa, among those adults aged 20-24, HIV positive females had completed significantly fewer years of education than HIV negative females. Condom use was much lower among rural (less educated) than urban (more educated) youth in South Africa. Higher levels of education have often been associated with condom use elsewhere in Sub-Saharan Africa (RHRU, 2004: 33; Luke, 2002:9-10).10 There is also strong evidence that the children of poorly

educated mothers are at relatively high risk of malnutrition and illiteracy (Smith and Haddad, 1999). The policy implication is that resources need to be focused on young females who are at risk of failing to attend school or of early school dropout, who are concentrated in the rural areas of Sub-Saharan Africa. Unfortunately, health and education expenditures are not currently concentrated on these rural young women (Section 3); the consequences for the quality of the labour that will be supplied by their children are extremely serious.

2.4 The Impact of HIV/AIDS on Child Labour Supply

Estimating the effect of HIV/AIDS on potential child labour supply depends, in part, on being able to assess the trend in child mortality among uninfected children. The United Nations Population Division projections indicate that child mortality among uninfected children is declining at very different rates in different Sub-Saharan African countries and that these countries also exhibit marked disparities in initial levels of child mortality. These differing "background" trends may exacerbate or mask the deterioration in mortality that is attributable to HIV. For example, a country with a high "background" level of child mortality, such as Malawi (Table 5), may continue to experience an overall decline in child mortality in the face of HIV, if it manages to sustain the rapid rate of decline in non-HIV related child mortality that it achieved in recent years.

In contrast, in countries with relatively low initial levels of child mortality (and high HIV prevalence) such as Botswana, child mortality has risen very sharply and HIV attributable mortality is now over 50 percent. In Uganda, declines in "background" mortality coincide with an estimated decrease in HIV prevalence, with the result that the fraction of child mortality attributable to HIV is declining. These contrasts in the proportion of overall child mortality that is attributable to HIV in different countries are illustrated in Figure 1. It may be concluded that trends in child mortality will differ between countries, not only because of the marked differences in the rates at which HIV prevalence increases, but also because of differences in non-HIV related child mortality. It is clear that expenditures to reduce non-HIV mortality could continue to play a major role in overall child mortality reduction in several African countries, quite apart from expenditures on the available cost-effective treatments to reduce rates of mother to child HIV-transmission (Wilkinson et al, 2000).

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Figure 1: HIV Population Attributable Fraction of Child Mortality, 1990 to 2001

Source: Zaba et al, 2003: 10.

In addition to the epidemiological and demographic factors differentially affecting future supplies of child labour, there is patchy evidence from studies sponsored by the ILO that some countries are much more likely to provide child entrants to the labour market than others. In other words, the proportion of children who work, as a

percentage of the age cohort, appears to vary a great deal between countries (Table 5, Column 3). This variation suggests that the circumstances that produce child labour are not immutable across the African region and that there is scope for government policy to reduce child labour.

However, not all of the work performed by children falls under the definition of “Child Labour” used by the ILO and incorporated in Table 5 (Column 4). Their approach excludes children engaged in work considered to be non-economic in nature, for example, domestic work within the household. However, such "non-economic" activities may themselves be substantial enough to prevent a child from attending school and so the use of the ILO definition is likely to bias downwards estimates of relevant child labour with a particular impact on the estimates of girls who are

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Table 5: Working children aged 5 to 17, in thousands (percent of cohort shown in brackets) Country Year of survey Total economically active (including “light” work) Child labourers (economic activities only) Total active (economic and non-economic) Ethiopia 2001 9,463 (52%) n.a. 15,468 (85%) Ghana 2001 2,475 (39%) 1,273 (20%) 5,661 (89%) Kenya 1998/9 1, 894 (17%) 1, 305 (12%) n.a.

Namibia 1999 72 (16%) n.a. n.a.

S. Africa 1999 1,979 (15%) 1,136 (8%) 6,040 (45%)

Tanzania 2000/1 4,736 (40%) 1,168 (10%) n.a.

Uganda 2000/1 2,677 (34%) n.a. n.a.

Zambia 1999 595 (16%) n.a. n.a.

Zimbabwe 1999 1,226 (26%) 356 (8%) n.a.

Sources: Federal Democratic Republic of Ethiopia 2001, Ghana Statistical Service 2003, Republic of Kenya 2001, Namibia Ministry of Labour 2000, Statistics South Africa 2001, Tanzania Ministry of Labour, Youth Development & Sports nd, Ugandan Bureau of Statistics nd, Republic of Zambia n.d., Zimbabwe nd

The inclusion of household work can lead to significant differences in the data on the overall number of working children, and on the gender burden of work. For example, the Ethiopia 2001 Child Labour Report (Federal Democratic Republic of Ethiopia 2001) finds that 85 percent of the 5-17 age group is involved in some kind of work, if "non-economic" activities are included (Table 5, Column 5). This falls to 52 percent if only directly productive activities are included. Considering only directly productive activities, 62 percent of boys are active and 42 percent of girls. However, the situation is reversed when housekeeping activities are taken into account, as these are

dominated by girls (with an activity rate of 44% for girls compared to 23% for boys). Also excluded from the ILO data on child labour are those children who are

economically active between the ages of 12 and 14, when they are considered to be engaged in light work (defined as less than 14 hours a week). Table 5 provides separate estimates of the number of all economically active children, including those engaged in light work (Column 3), as well the ILO's estimates of child labour

(Column 4). It also provides the few survey estimates of the total number of active children that include children involved in "non-economic" activities (Column 5).11 As well as substantial differences between African countries, the ILO-sponsored studies also show substantial differences in the supply of child labour within countries. These are complex; they cannot be simplified into a rural- urban

dichotomy, or summarised by reference to the characteristics of children living in poorer as opposed to wealthier households.12 In fact, studies in different countries do

11

It should be noted that the surveys that were the sources for the data in Table 5 did not always use the same approaches and definitions. They are not strictly comparable and cannot be an adequate basis for published estimates of the percentage of the cohort aged 5 to 14 years that is working in the Sub-Saharan African region as a whole (Table A13).

12

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not agree on the degree to which household poverty can explain the pattern of child labour. Early entry into the labour market and incomplete basic education depend on changing sets of factors that are likely to vary from household to household and to be affected by changes in demand and supply conditions, as well as by the pattern of state expenditure on schooling and rural infrastructure.13 For example, survey data from the Kagera region of Tanzania indicate that households increased their use of child labour in response to sharp declines in the total value of crops farmed due to pests, diseases and calamities such as fires (Beegle et al, 2003). Similarly, a study based on LSMS data from Cote d’Ivoire suggests that economic recession led to a contra-cyclical general rise in child economic activity (Grootaert, 1998:13). Grootaert identified five key factors which affected a household’s decision to supply child labour: the age and gender of the child, the education and employment status of parents, the availability of within household employment opportunities, the

household’s poverty status and its geographic location. Not only was labour market participation likely to increase with age of the child, but there were also clear trends by gender, with girls less likely to attend school and more likely to engage in

household tasks. In rural areas, having a female household- head meant that a child was more likely to work. In addition, parents with no or low education were more likely to have children engaged in work. Grootaert describes the presence of household enterprises as a ‘double-edged sword’ (ibid, 1998:65). On the one hand, increased income will decrease the likelihood that a child will work, although he noted that ownership of a household enterprise was a positive correlate of poverty in Cote d’Ivoire. On the other hand, the presence of a household enterprise meant that it was more likely that a child would work.

Similarly, an econometric analysis of Ghanaian data (Canagarajah and Coulo mbe, 1997) suggests that poverty is not the main factor behind child labour, with a statistically weak relationship (see also Nielsen 1998, who finds no positive relationship between poverty and child labour in Zambia). Instead, family characteristics had a strong role to play in the decision over school or work, with households who earned a larger share of their income from family enterprises, farming or otherwise, having a higher child labour participation rate (ibid: 27).14 Another study of Ghanaian data contradicts some of these conclusions and does find a positive relationship between poverty and child labour, as well as evidence of a gender gap in child labour linked to poverty, with girls as a group as well as across urban, rural and poverty sub-samples being consistently more likely to engage in percent of children were likely to be economically active in urban areas, compared to 23 percent in rural areas (Republic of Zambia n.d.:25). Participation rates also varied widely by province, with a participation rate of 25 percent in Southern province and one of only 4 percent in Lusaka province. The South African study produced more detailed disaggregated data, reporting the prevalence of children working in either productive or domestic tasks in a formal urban area (23 percent), informal urban area (23 percent), commercial farming area (48 percent) and other rural area (64 percent)

(Statistics South Africa 2001:35). Other studies have shown marked differences between child workers within the same country in term of the sectors in which they work and their age- and gender-specific participation rates.

13

The influence of state expenditure on schooling on the age-specific participation rates of girls in the casual agricultural wage labour markets in India and, therefore, on real wages and poverty in rural India, has been explored by Sen and Ghosh (1993).

14

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harmful child labour than boys (Blunch and Verner, 2000: 3). Similarly, an

econometric analysis of the ILO data on economic activity within SSA countries finds a strong and significant statistical relatio nship between the incidence of poverty and the prevalence of child economic activity (Admassie, 2002:267). Whilst the impact was small, poverty was one of the most significant variables arising from his study.15 The supply of child migrant labour from Benin, where 8 percent of all rural children aged between 6 and 16 years have left their parental households to work (half of them leaving for other countries, with boys heading for plantations in the Cote D'Ivoire and the girls mainly looking for domestic service in Gabon), cannot be explained by the relative poverty of the migrant-sending households. In fact, relatively wealthy rural households may be more likely to be able to finance such migrations (Andvig et al, 2001: 13). Elsewhere, when long-distance migration is not involved, there is evidence that rural child domestic servants do come from extremely poor households, or are orphans (Sender et al, 2004). Since the market for domestic servants is probably the most extensive market for child labour in Sub-Saharan Africa, it is remarkable how little research has been conducted into the poverty of the households supplying the children concerned, into remittance behaviour, or into these children's real wages and working conditions. The economic history of the developed economies suggests that a very high and increasing proportion of young girls will, over the next few decades of economic development in Africa, enter the labour market as domestic servants (Roberts, 1995; Vickery, 1998; Bras, 2003).

There has also been little research that focuses on the specific issue of the impact of HIV/AIDS on the labour market participation of children. The ILO has not attempted to include child labour in its estimates of the impact of HIV on the projected size of the labour force. Its recent projections of the HIV-affected and non-affected labour force are based on the numbers of people defined as economically active between the ages of 15 and 64 years, ignoring the labour force aged between 5 and 14 years (ILO, 2004a: 66). The few available micro-studies of the effects of HIV/AIDS on rural households have typically been confined to geographic areas known to have high HIV prevalence. Their findings cannot, therefore, be extrapolated to a national scale. Besides, they suggest that rural responses to the death of a prime age adult are heterogeneous, with affected households replacing agricultural labour through the arrival of new adult members, through labour hiring and by changing their cropping patterns and varying the input mix, rather than by resorting to child labour (Mather et al, 2004).

Micro data from 24 districts in rural Kenya suggest that households adjust, after experiencing the death of a working age female (who is not the head of the household or the female spouse of the head of household), by attracting “boys” into the

household. The labour of these newly resident young male relatives appears to

15

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substitute for the tasks previously performed by the deceased woman, although no information is provided on whether or not these boys should be considered as new entrants into the child labour force (Yamano and Jayne, 2004:102).16 A larger scale study in Tanzania found that, “Analysis of farm and chore hours across demographic groups generally found small and insignificant changes in labor supply of individuals in households experiencing a prime-age adult death. The lack of an increase in hours … is notable for children in particular for whom deaths are presumed to result in higher farm hours assuming there will be an acute shortage of farm labor” (Beegle, 2003:24-5).17

Thus, there is no reliable direct evidence suggesting that AIDS orphans are more likely than other orphans or children to enter the market for child labour. Whether or not children and orphans enter labour markets appears to be context specific, with some orphans and AIDS orphans having access to household or extended family resources that enable them to avoid premature entry, even if they experience serious emotional distress and other, long-term adverse consequences. Nevertheless, the HIV/AIDS epidemic is clearly having a massive impact on the total number of

orphans in Sub-Saharan Africa. At the end of 2001, the proportion of orphans in SSA who were AIDS orphans has been estimated at 32 percent. By 2010, it has been estimated that the proportion will be 48 percent. Those countries with the highest prevalence of HIV already have the highest prevalence of orphans, although countries that have experienced violent conflict, such as Mozambique and Rwanda, also have a large proportion of children who are orphaned (Grassley and Timaeus, 2003, 4-6). The percentage of the relevant age group (0-14 years) that is orphaned varies dramatically between countries, from less than 6 percent (Ghana) to 12 percent or more in Uganda and Mozambique (ibid: 10). The ILO estimates the absolute number of orphans in Sub-Saharan Africa as a result of HIV/AIDS in 2003 (12 million),18 but the inter-country range is striking, from only 65,000 children in Swaziland to about one million children in Uganda, Tanzania and South Africa (Table 6).

16

Another Kenyan micro study refers to anecdotal evidence that those workers on tea estates who were suffering as a result of HIV/AIDS were more likely than a control group of workers to "bring helpers" with them to pluck tea (Fox et al, 2004: 323). It is likely that some of these family "helpers" were children.

17

Another Tanzanian study, comparing the 2000/01 Integrated Labor Force Survey with results from the 1990/91 Labor Force Survey, comes to different, though tentative, conclusions. The authors found a dramatic increase in labour force participation rates for children aged 10-14, and a much milder increase for those aged 15-19, while education transition matrices drawn from enrolment data suggest an increased tendency during the 1990s to exit primary school. However, these two labour force surveys are not comparable. Therefore the recorded increase in child labour participation in the period between the surveys may not, in fact, reflect the spread of the epidemic or labour market realities (Arndt and Wobst, 2002: 8-9).

18

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Table 6: HIV Prevalence and Numbers of Orphans, 2003

Countries in Alphabetical Order

Estimated HIV Prevalence in Persons 15-49 Years (%)

2003

Estimated Total Number of Orphans (0-17 Years) as result of HIV/AIDS

2003 Côte d’Ivoire 7.0 310,000 Ethiopia 4.4 720,000 Ghana 3.1 170,000 Kenya 6.7 650,000 Lesotho 28.9 100,000 Malawi 14.2 500,000 Mozambique 12.2 470,000 South Africa 21.5 1,100,000 Swaziland 38.8 65,000 Uganda 4.1 940,000

United Republic of Tanzania

8.8 980,000 Zambia 16.5 630.000 Total (Sub-Saharan Africa, 35 Countries, Weighted ) 7.7 12,016,300

Total (Asia, 5 countries) 0.4 2,053,000

Source: ILO, 2004: 88-9

In most Sub-Saharan African countries, a high proportion (about half) of all orphans is currently in the age-group 10-14 years. Therefore, large numbers of orphaned children may confidently be expected to enter labour markets in the next few years. The quality of these new entrants, the degree to which their orphan status will directly have compromised their health, nutrition and levels of education, is a key policy issue. This is discussed below (Section 3.2), after examining the more general question of the scale of projected increases in the supply of youth to the labour market.

2.5 The Impact of HIV/AIDS on the Labour Supply of Youth

The relatively high proportion of young people in the working age population of all Sub-Saharan African economies compared to other developing regions has already been noted (Table 3), as have the important differences in age-composition across African economies. Fertility rates in Sub-Saharan Africa are, in general, declining at a slower rate than in other developing regions and the share of youth, (i.e. 15-24 year olds), in the total population of working age in the sub-continent is projected to remain more or less constant at about 36 percent between 2000 and 2015. This is a very much higher share for youth than, for example, in the South-Eastern Asian economies, where the youth share in the total working age population is projected to decline significantly by 2015 (Table A2).

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regions, where the youth labour fo rce will increase by less than 3 percent, compared to an increase of over 26 percent in the adult labour force (Table A2). Figure 2 provides a graphic illustration of the historic growth in the difference between the share of young people in the population of Africa and the share of young people in the populations of other developing regions.

Figure 2: Median Age of the population in Africa, Asia and Latin America

Source: Berthélemy, 2004: 25

The slow rate of increase in the labour supply of youth in some non-African

developing regions is not only attributable to more rapidly declining fertility trends, but also to the fact that more youths are staying in education for longer (ILO, 2004b: 6). Therefore,in the Sub-Saharan African context, there is scope for policies to reduce the very rapid rate of growth in the number of new young entrants into the labour market. In the short- to medium-term, a reduction in primary school dropout rates and an increase in the transition rate from earlier to later levels of the education system are the recommended supply reducing policies. These policies are much more likely to be efficient in improving the quality of youth labour supplies than attempts to “keep young people off the streets” by offering training of various kinds for those who have already left school (Godfrey, 2003: 18). (Some of the inefficiencies of expenditures on youth training, as well as the pro-rich bias of other policies aimed at improving the quality of young labour market entrants, will be discussed in Section 4.4 below).

2.6 Summary and Conclusions

The starting point for analysing labour supply in Sub-Saharan Africa is that there are gaping holes in the available data and that published estimates of different

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are covered by Labour Force Surveys and Population Censuses are often based on estimates and projections relying on guesstimates about population dynamics and the distribution of the labour force by sector, occupation and status. In addition, there is remarkably little good quality information that would make possible an accurate monitoring of levels and trends in national HIV prevalence rates. The intersection of inadequate HIV data collection and widespread shortcomings in broader demographic data mean that policy makers are limited in their ability to understand accurately and effectively respond to labour supply issues in the region.

Nonetheless, Section 2 has pieced together a coherent analytical story about the quantity dimension of labour supply in Sub-Saharan Africa. The overriding theme of this analysis is the striking inequalities in labour supply characteristics, both between countries and, in some ways even more importantly, within countries. This section concentrates particularly on inter-country variations, while later sections focus more sharply on intra-country inequalities.

The size of populations varies enormously and there are significant differences in the projected growth rates of these populations. The current age structure of the

population, and hence the proportion of the population of working age, also varies significantly from country to country. Thus the median age of Ugandans, in 2000, was estimated at 15.1 years, compared to 18.8 years in Ghana and 22.6 years in South Africa. While only 12 percent of Uganda’s population was urban in 2003, 62 percent of Mauritanians lived in urban areas; and the urban population is projected to grow more rapidly in some countries (Kenya, Malawi, Mozambique, and Tanzania) than in others (Cote d’Ivoire, South Africa, and Zambia).

HIV/AIDS will continue to have a profound, though varying, effect on many African countries. The direct impact is especially great on girls and women. Throughout Sub-Saharan Africa young women (aged 15-24) are twice as likely as young men to be living with HIV/AIDs, though in South Africa they are estimated to be three times more likely than young men to be infected. Especially in countries, and areas of countries, with very high prevalence, HIV/AIDS has complex implications not just for the age composition of the female labour force but also for wider and

inter-generational implications for the quantity and quality of labour supplies. Meanwhile, it is extremely difficult, given presently available evidence, accurately to assess and predict the impact of HIV/AIDS on child labour supplies. It is also difficult to extract this impact from the varying ‘background’ child mortality in uninfected children. The proportion of children who work, as a percentage of the age cohort, does seem to vary considerably between countries, which may suggest some scope for government policies to reduce the incidence of child labour. To some extent, children’s labour market participation is influenced by levels of poverty; however, there are other family characteristics that influence child labour supplies, and these sometimes appear stronger than income leve ls. Furthermore, there are dramatic differences between countries in the percentage of the relevant age group that is orphaned (e.g. less than 6 percent in Ghana but more than 12 percent in Uganda and Mozambique) as well as in the absolute numbers of orpha ns.

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proportion is expected to remain fairly constant between 2000 and 2015, while it is projected to decline, e.g., in South-Eastern Asia. Differences in fertility rates clearly affect this phenomenon. However, it is also affected by the fact that more youths stay in education longer in other developing regions. Therefore, education policies may be effective in counteracting the effect of the relatively slow decline in fertility rates in Sub-Saharan Africa. These policies would need to focus on reducing primary school dropout rates and increasing the transition from lower to higher levels of education.

3. The Quality of Labour in the Future: Nutrition, Health, and Educational Status

3.1 Cross-Country Comparative Data: Life Expectancy, Literacy, Nutrition and Mortality

At the most basic level, since productivity is partly determined by years of experience in work, relatively short working lives, or a small share of older people in the

population aged 15-64 years (see Table 3), mean that low levels of life expectancy are likely to have directly adverse effects on labour productivity. Moreover, life

expectancy may also be considered a good proxy for several other aspects of

individuals' welfare that will influence their capacity to work productively, including their nutritional status and morbidity, etc (McGillivray and White, 1993). It is, therefore, important to emphasise the scale of differences in life expectancy between countries, and to note trends in cross-country differences in the size of the gender gap in life expectancy, since this gap is likely to have important effects on the quality of future labour supplies. Similar arguments apply to differences in literacy rates across countries and to differences between countries in the size of the gender literacy gap, although the data on literacy is generally considered to be less robust and comparable than the data on life expectancy.19

Table 7 provides UN Population Division life expectancy estimates for two periods, 2000-2005 and 2010-2015. In the first period, the range of female life expectancy across African countries is huge - from about 30 years to about 60 years - and females can expect to live 4- 5 years longer than males in some countries, while in others their life expectancy is about the same as that of males. By the second period these

significant differences between countries are projected to increase. For example, female life expectancy in Ghana will be more than 33 years longer than in Swaziland and female life expectancy will have fallen below that of males in several countries. These differences between countries may be explained, in part, by the differential prevalence and stages of HIV/AIDS (as discussed in Section 2, above), but there are

19

Most of the available data on is based on reported rather than tested literacy and in some cases are derived from other proxy information. Moreover, definitions are not necessarily standardized. And the field experience of the authors of this paper suggests that it is difficult to discern the value of a

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other indicators of women's status that also vary dramatically between countries and are not closely correlated with national HIV/AIDS statistics. For example, over half of young women were illiterate in Ethiopia, Mauritania, Senegal and Mozambique in 2000, while less than 15 percent of young women were illiterate in Ghana, Kenya, Lesotho, South Africa, Swaziland, Tanzania and Zambia (Table 7). Some countries already had small or no gaps between the illiteracy rates of young females and males in 2000, but others had very large gender gaps (of the order of 29 percentage points in 2000) and the gaps will still be large (between 10 and 17 percentage points) in

Mozambique, Malawi, Senegal and Mauritania by 2015.20

It is safe to predict that the children of illiterate mothers will face relatively high risks of undernutrition, morbidity and inadequate schooling; they will enrol later, leave at an earlier age, and perform relatively poorly in educational attainment tests

(Morrisson, 2002: 10; Filmer, 2003) and, as a consequence, their labour productivity will be low. Thus, the quality of the future supply of labour in six countries where between a quarter and half of young women remain illiterate in 2015 is likely to be very inferior to that in the other eight countries listed in Table 7.

Table 7: Estimated and Projected Life Expectancy at Birth and Youth Illiteracy Rates, By Gender

Life Expectancy at Birth

(Medium Variant) 2000-2005*

Life Expectancy at Birth

(Medium Variant) 2010-2015* Illiteracy Rate (%) 15-24 Years Old** 2000 Illiteracy Rate (%) 15-24 Years Old** 2015

Female Male Female Male Female Male Female Male

Côte d’Ivoire 41.2 40.8 45.8 45.0 48 29 29 20 Ethiopia 46.3 44.6 48.8 47.5 51 39 30 26 Ghana 59.3 56.5 62.9 60.5 11 6 3 3 Kenya 45.6 43.5 44.9 45.0 6 4 1 2 Lesotho 37.7 32.3 32.3 32.0 1 17 1 13 Malawi 37.7 37.3 39.1 40.2 39 19 26 13 Mauritania 54.1 50.9 58.1 54.9 59 43 50 40 Mozambique 39.6 36.6 39.5 39.1 54 25 32 15 Senegal 55.1 50.8 59.1 54.8 58 40 39 28 South Africa 50.7 45.1 40.5 42.3 9 9 6 6 Swaziland 35.4 33.3 29.6 31.1 9 10 4 5 Uganda 46.9 45.4 56.2 53.8 28 15 15 9 Tanzania 44.1 42.5 47.4 45.6 12 7 4 4 Zambia 32.1 32.7 34.6 35.9 14 9 7 5 SSA Total (35 Countries, Weighted) 46.7 44.8 48.0 47.3 Eastern Asia 74.7 69.7 76.5 70.4 South-central Asia 63.9 62.5 66.9 64.9

*United Nations Population Division (2003); ** http://www.uis.unesco.org (July 2004).

The scale of the difference in predicted outcomes for children born in different Sub-Saharan African countries is also reflected in comparative data on child nut rition and child survival rates (Table 8). Many studies have demonstrated associations between undernutrition and growth retardation, impaired mental development and increased

20

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susceptibility to infectious diseases. In Sub-Saharan Africa, recent work suggests that undernutrition and micronutrient deficiencies are causing large numbers of children to suffer from malaria, while Vitamin A deficiency, affecting between 28 and 35 percent of children in different parts of Africa, is a major cause of blindness (Caufield et al: 2004). In addition, micro- level evidence demonstrates a significant relationship between preschooler nutritional status and the number of years of schooling they can complete, as well as their labour productivity as adults (Alderman et al, 2003). Thus, the data on the prevalence of undernutrition presented in Table 8 suggest that the quality of the future labour force in Ethiopia, where more than half of children under five years old suffer from moderate or severe stunting and 16 percent of children are severely underweight, will be much lower than the quality of future labour supplies in other Sub-Saharan African countries (including Cote D'Ivoire, Ghana, Lesotho, Senegal and South Africa), where roughly a quarter or less of children suffer from moderate and severe stunting and six percent or less suffer from severe underweight.

The differential risks faced by children are well illustrated in the data on the levels and trends in Under-Five Mortality Rates (Table 8). Some countries combine both very high levels of Under-Five Mortality and a weak record in reducing this rate over the period 1990 to 2002 (Zambia, Mauritania). Others have quite high current rates and a disastrous record in terms of reducing Under-Five Mortality Rates (Swaziland, Kenya, and Cote d'Ivoire). In contrast, Malawi and Mozambique have achieved large reductions in the Under-Five Mortality Rate since 1990, but still have extremely high current rates. Ghana, which currently has an Under-five Mortality Rate that is about half that of Mozambique and Zambia, has been successful in reducing its rate (by 21 percent since 1990). These results confirm the heterogeneity of Sub-Saharan African

Table 8: Under-Five Malnutrition, Mortality and Reductions in Mortality Rates

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Source: UNICEF, Basic Indicators 2004 ( http://www.unicef.org/sowc04/sowc04_tables.html)

countries in terms of their current ability to ensure child survival and their recent record in achieving improvements in child survival.22 They also provide another clear, policy relevant indication of those countries where the quality of the current female labour force is likely to be particularly low, since maternal undernutrition and illiteracy are strongly associated with high rates of child mortality.

Sub-Saharan Africa's development experience since 1945 is often unfavourably compared with the development performance of certain East Asian and Latin

American developing economies. Such comparisons too often ignore the fact that, for example, 80 percent of adult females were already literate in Chile by the early 1950s, more than 50 percent were literate in Mexico and the Philippines, and over a third were literate in Thailand. They also ignore the fact that, in 1960, the average level of schooling of the working age population was only 1.3 years in Sub-Saharan Africa, compared to 3.8 years in Latin America and the Caribbean and 2.3 years in East Asia and Pacific (OECD New Database, 2002:12).23 Thus, the starting points for

improvements in human development and labour productivity were by no means comparable, suggesting that considerable caution should be applied before assuming that all Sub-Saharan economies should or could ha ve replicated some of the post-war successes of the NICs (Sender, 1999: 92; Platteau, 1996).

3.2 Intra-Country Differentials in Education and Health Status

If appropriate policies are to be developed, it is not sufficient to highlight enduring disparities in the growth rates of labour supply and in the quality of labour available in different Sub-Saharan economies. It is also necessary to emphasise the degree of differentiation within each of these economies. A focus on inter-country differences may avoid the dangers of crude Africa-wide policy prescriptions to improve the quality of labour supply. It might also support arguments for reallocating Official Development Assistance towards particularly vulnerable countries in Africa, ending the trend bias in the 1990s away from the poorest countries (White, 2002: 12). However, inequalities in the intra-country distribution of education, health, sanitation and other services mean that the labour supply from some regions, districts or

households will continue to exhibit very different capacities to work productively. There has been a great deal of recent research comparing the relative degree of inequality in the health and education of the populations of countries in SSA. This research, based on comparable DHS data, confirms the persistence of substantial variation in, e.g., the extent of the urban-rural divide in standards of living. Thus, although living standards in rural areas of SSA generally lag far behind those in urban areas, the size of the lag is very much greater in some countries than others.

However, focusing on rural education/health standards would not be sufficient to reduce national inequalities, since most of the inequality in these countries is comprised of inequalities within rural and urban areas (Sahn and Stifel, 2004).

22

Econometric work on the determinants of the capacity of different Sub-Saharan African countries to reduce under-five mortality is noted below in Section 4.3.

23

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Inequalities in several indicators of human welfare are far greater in rural than in urban areas. For example, the Theil index of education inequality, based on attainment data (i.e. the ultimate year of schooling for the population of working age24), is much higher in the rural than the urban areas of all countries in Table 9.25

Table 9: Inequalities in Educational Attainment

Country: (date of DHS)

Percentage Without Any School Theil Inequality Measures

National Rural Urban Gini National Rural Urban

Cote d'Ivoire (1994) 48 57.3 36 0.622 0.777 0.978 0.553 Ghana (1998) 21.1 26.9 11.1 0.378 0.318 0.397 0.185 Kenya (1998) 6.3 7 4.3 0.253 0.135 0.142 0.096 Malawi (1992) 33.2 36.6 14.3 0.522 0.537 0.587 0.245 Mozambique (1997) 33.5 40.8 13.5 0.547 0.582 0.686 0.264 Senegal (1992) 64.3 83.9 38.4 0.796 1.551 2.654 0.871 Tanzania (1999) 18.2 21.8 8.7 0.305 0.265 0.303 0.163 Uganda (1995) 22.2 24.8 8.1 0.431 0.37 0.399 0.168 Zambia (1996) 9.7 15.2 3.1 0.305 0.193 0.259 0.097 Source: Sahn and Stifel, (2004, 24)

Table 9 shows that rural inequality in education attainment is generally high, but far greater in some countries than in others. For example, the rural Theil index for Senegal is 2.654, compared to a rural Theil index of 0.142 for Kenya. Similarly, indicators of the health status of rural and urban populations show significant

variations in the size of rural- urban gaps. Theil indices confirm that rural inequality in health is far worse in some countries than in others (Table 10).26 For example the rural Theil index for health inequality is 1.7229 in Kenya and only 1.012 in Tanzania.

24 Here defined as people 15 to 40 years old.

25 The Theil measure is used because it is decomposable into groups, i.e. it can be decomposed into the sum of within and between region (urban or rural) contributions to inequality, to indicate the degree to which a reduction in inequality between rural and urban areas would reduce overall inequality. This measure is the basis for the conclusion that the contribution of inequality within rural regions predominates in Sub-Saharan Africa (ibid: 22).

26

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Table 10: Rural and Urban Health Inequality

Country

(and DHS Date)

Gini Theil Measure (NCHS Adjusted)

Rural Theil Measure (NCHS Adjusted) Urban Theil Measure (NCHS Adjusted) Cote d'Ivoire (1994) 0.034 1.241 1.4337 0.7108 Ghana (1998) 0.0331 1.0964 1.1325 0.8554 Kenya (1998) 0.0379 1.759 1.7229 1.6867 Malawi (1992) 0.0356 1.4337 1.4096 1.2048 Mozambique (1997) 0.0383 1.8072 1.9036 1.4096 Senegal (1992) 0.0339 1.2169 1.3373 0.8193 Tanzania (1999) 0.032 0.9639 1.012 0.4578 Uganda (1995) 0.0346 1.3735 1.3976 1 Zambia (1996) 0.0355 1.4217 1.5904 1

Source: Sahn and Stifel, (2004;, 25)

The data contained in Tables 9 and 10, showing large disparities between countries in measures of health and educational status, as well as very different patterns and degrees of inequality, derive from research that does not attempt to analyse

correlations between education/health status and income or other indicators of social stratification. However, the gaps between the health and educational status of poor and better-off households in Sub-Saharan Africa are very substantial and the

asset/expenditure levels of African households do appear to be a good, if not perfect, predictor of the health and educational status of household members (Houweling et al., 2003; Gwatkin and Rutstein, 2000; Filmer and Pritchett, 2001). The evidence (see Table A4) indicates an almost complete lack of basic educational opportunities for poor girls in Ethiopia, Senegal, Mozambique and Cote D’Ivoire. Poor girls are significantly more likely achieve a basic education in Ghana, Malawi, Zambia and Tanzania, but only Kenya and South Africa have achieved nearly universal grade four attainment for both girls and boys (Figure 3). One clear implication is that the

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